
<div th:fragment="qyxqModelEasy">
	<div class="easyui-panel" title="居民基本信息" data-options="tools:'#toolJmxx'">
		<!--<div id="toolJmxx">
			<span onclick="checkImage()">家签集成信息</span>
			<div id="jqjctBox" style="display:none;">
				&lt;!&ndash;图片宽度设为：100% 可以让图片在所有的父级中占满，包括layer.open()的目标窗口&ndash;&gt;
				<img th:src="@{/service/image/jqjcst.jpg}" width="100%"/>
			</div>
		</div>-->
		<table id="jmxxTable" class="form-table">
			<tr>
				<td class="td-text"><label>居民姓名：</label></td>
				<td class="td-content"><input type="text" name="XM" id="XM"
					autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"> <input
					name="JMXXID" class="form-control" style="display: none;">
				</td>
				<td class="td-text"><label>性别：</label></td>
				<td class="td-content">
					<!-- <select name="XB" id="XB" class="cacheTable dataField form-control" cacheTable="TB_ZY_XB" quick-config="label:'性别', validateProxy:'notNull'"   >
						</select> --> <input type="text" name="XB" id="XB"
					autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control">
				</td>
				<td class="td-text"><label>证件号码：</label></td>
				<td class="td-content"><input type="text" name="ZJHM" id="ZJHM"
					autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>出生日期：</label></td>
				<td class="td-content"><input type="text" name="CSRQ" id="CSRQ"
					readonly="readonly" autocomplete="off"
					class="layui-input dataField form-control"></td>
			</tr>
			<tr>
				<td class="td-text"><label>就诊卡号：</label></td>
				<td class="td-content"><input type="text" name="JZKH" id="JZKH"
					autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>手机号码：</label></td>
				<td class="td-content"><input type="text" name="SJHM" id="SJHM"
					autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>家庭地址：</label></td>
				<td class="td-content" colspan="3"><input type="text"
					name="JTZZ" id="JTZZ" autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control isTitle"></td>
			</tr>
			<tr>
				<td colspan="8">18岁以下未成年人、精神疾病患者等对象，应由其监护人代为签约，增加以下内容：</td>
			</tr>
			<tr>
				<td class="td-text"><label>监护人姓名：</label></td>
				<td class="td-content"><input type="text" name="JHRXM"
					id="JHRXM" autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>与甲方关系：</label></td>
				<td class="td-content"><input type="text" name="YJFGX"
					id="YJFGX" autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>联系电话：</label></td>
				<td class="td-content"><input type="text" name="LXDH" id="LXDH"
					autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>身份证号：</label></td>
				<td class="td-content"><input type="text" name="SFZH" id="SFZH"
					autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
			</tr>
		</table>
	</div>
	<div class="easyui-panel" title="居民基本情况">
		<table class="form-table">
			<tr>
				<!-- <td class="td-content" colspan="8" style="border: none;">
						<ul id="rqflUl">
						</ul>
					</td> -->
				<td class="td-text"><label>居民基本情况：</label></td>
				<td class="td-content" colspan="5"><input type="text"
					name="RQFLMC" id="RQFLMC" autocomplete="off" readonly="readonly"
					class="layui-input dataField form-control"></td>
			</tr>
		</table>
	</div>
	<div class="easyui-panel" title="家庭成员"
		data-options="tools:'#toolJtcygl'">
		<table id="jtcyTable" class="form-table">
		</table>
	</div>
	<div class="easyui-panel" title="签约信息" data-options="tools:'#toolQyxx'">
		<div id="toolQyxx">
			<span onclick="findLsjl()" href="javascript:void(0)">历史记录</span>
		</div>
		<table id="qyxxTable" class="form-table">
			<tr>
				<td class="td-text"><label>服务包：</label></td>
				<td class="td-content" colspan="5"><input type="text"
					id="FWBMC" name="FWBMC" readonly="readonly" autocomplete="off"
					class="layui-input form-control isTitle"></td>
			</tr>
			<tr style="display:none">
				<td class="td-text"><label>医保服务项：</label></td>
				<td class="td-content" colspan="5">
					<input id="YBFWX" readonly="readonly" autocomplete="off"
						  class="layui-input form-control isTitle">
				</td>
			</tr>
			<tr>
				<td class="td-text"><label>所在医院：</label></td>
				<td><input type="text" id="SZYY" name="SZYY"
					readonly="readonly" autocomplete="off"
					class="layui-input form-control isTitle"></td>
				<td class="td-text"><label>签约团队：</label></td>
				<td><input type="text" id="TDMC" name="TDMC"
					readonly="readonly" autocomplete="off"
					class="layui-input form-control isTitle"></td>
				<td class="td-text"><label>签约医生：</label></td>
				<td><input type="text" id="QYYS" name="QYYS"
					readonly="readonly" autocomplete="off"
					class="layui-input form-control"></td>
			</tr>
			<tr>
				<td class="td-text"><label>签约日期：</label></td>
				<td><input type="text" name="QYSJ" id="QYSJ"
					readonly="readonly" autocomplete="off"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>生效日期：</label></td>
				<td><input type="text" name="SXSJ" id="SXSJ"
					readonly="readonly" autocomplete="off"
					class="layui-input dataField form-control"></td>
				<td class="td-text"><label>结束日期：</label></td>
				<td><input type="text" name="JSSJ" id="JSSJ"
					readonly="readonly" autocomplete="off"
					class="layui-input dataField form-control"></td>
			</tr>
		</table>
	</div>
</div>